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Online ISSN 1827-1596
CRITICAL AND INTENSIVE THERAPY
Salemi S. 1, Sparacia B. 1, Costa R. 1, Cracchiolo A. N. 1, Gristina E. 2, Sansone A. 3
1 Università degli Studi - Palermo, Istituto di Anestesia, Rianimazione e dell’Emergenza;
2 Università degli Studi - Palermo, Cattedra di Terapia Intensiva;
3 Università degli Studi - Palermo, Cattedra di Anestesia e Rianimazione
The cannulation technique of the subclavian vein by the external jugular vein is described.
Objective. To point out this simple and safe method without complications deriving from the direct needle-prick of the subclavian vein.
Methods. Experimental plan. The comparative study includes 30 patients in the resuscitation department during the second half-year in 1996. Place. Resuscitation Department of the University Polyclinic in Palermo. Patients. 30% of these patients were male and 70% were female; coagulative serious disorders were present in some patients, in others the coagulative picture was unknown. Interventions and observations. The modified Seldinger technique has ben used, introducing a J wire through the needle cannula put in the external jugular vein, taking care not to exceed the lenght of the latter with the J wire.
Less rigid and small catheters have been used which can fluctuate in the running blood and be carried in the superior vein cava. Once the subclavian vein has been cannulated, a Rx graph control of the thorax was made, sho-wing the excellent position of the catheter.
Results. Only one failure, but this technique has not showed complications.
Conclusions. This technique finds applications in all situations of extreme emergency, in which on the one hand it needs a central blood vessel, on the other there are hemorrhagic problems or there isn’t any possibility to do a coagulative screening in short time.